Leveraging the Value of Mystery Shopping

By: Clint Maun, CSP

Mystery shopping has become increasingly popular in healthcare settings, as it provides a quick and objective method to identify and evaluate service performance. A mystery shopping project often begins when an incognito shopper makes an inquiry call to a healthcare facility asking for information and continues through to a visit to the facility, sometimes extending through a second and third visit. It concludes when the mystery shopper reports on his or her experiences. Mystery shoppers can provide feedback on things such as first impressions of the facility, customer service, and the marketing and rapport-building skills of the sales staff.

Mystery shopping can help healthcare organizations identify several key issues, including the following:

The care and treatment of patients

Why you may be losing business

Marketing, sales and service problems

The responsiveness (turn around time) and sales skill of your staff

How your organization is perceived in the community

If your organization is being recommended by any other sources

How your organization's staff handles inquiries

In addition to identifying issues at your own facility, mystery shopping can provide huge benefits when used at competitor sites. Mystery shopping at a competitor site can prove to be a lesson in humility, as it demands the wisdom to acknowledge that another organization may be doing things better than you. However, if you're able to set your personal feelings aside, there's a lot you can learn from shopping at a competitor site. Mystery shopping at the competition enables your healthcare facility to identify, learn and implement industry best practices and therefore gain a competitive advantage.

Of course, some managers believe that they already have their fingers on the pulse of their industry and how their organization is performing. But ask yourself: When was the last time your organization formally (and objectively) evaluated service and operations? If the answer is, "It's been awhile," or "I can't remember", then it's probably the right time to mystery shop at your organization as well as the competition.

At the end of the day, the level and quality of service you deliver to your patients and customers is vital to your company's success. Your customers' total experience with your company and your staff ultimately dictate whether your company will succeed or fail. Simply having expectations about what sort of experience your customers and patients should have is not enough. To realize positive results, you must inspect and measure. Objective, anonymous, third-party assessments of the customer experience will provide the information you need to ensure that customers' actual experiences match company expectations. Mystery shopping programs provide this service and opportunity. Moreover, mystery shopping can deliver insights across stakeholders-including physicians, nurses, CNAs, patients and consumers-to help you anticipate and impact customer behavior so you can optimize sales, brand, treatment, communications, and performance.

Measuring the Value

As with any program or expenditure, executive management and administrators will want to know mystery shopping's return on investment (ROI). The ROI of mystery shopping programs can be readily measured, provided that the results are followed up on and effectively used to change employee behavior. For example, if a mystery shopping program reveals that fifty percent of the time employees fail to greet customers and visitors when they enter the facility, the company might take specific steps to ensure that employees know they must acknowledge customers within thirty seconds of arrival. Subsequent mystery shopping might reveal that customers are greeted within thirty seconds, ninety-five percent of the time. The return for the company is that a specific expected employee behavior has improved by forty-five percent. The exact financial value of this and similar types of behavior improvement may be hard to gauge, but consider this: A customer who is made to feel welcome and valued is far more likely to do business with your company than a customer who is ignored.

Of course, mystery shopping is valuable in ways that can't be readily measured. By identifying issues that otherwise may have gone unnoticed, mystery shopping can prevent the loss of business and negative perceptions. However, measuring something that has been prevented or didn't happen is nearly impossible to do. Mystery shopping programs can prove extremely valuable in ways that may not be readily measured for two primary reasons:

Most customers/patients who have unsatisfactory experiences will not complain, they will just never come back.

Dissatisfied customers are likely to tell many others about their experience, who in turn probably will avoid doing business with you.

It's critical to keep these items in mind when measuring and proving the value of mystery shopping programs.

The More You Put In, The More You'll Get Out

If your organization wants to realize a positive ROI out of a mystery shopping program, it must take the feedback and results and turn them into action. After all, if the data isn't being used to initiate change or enhance programs, then it's really all for nothing.

Healthcare organizations across the country are leveraging mystery shopping to improve service and increase business. Below are some prime examples of how organizations turned their mystery shopping feedback into action.

An Ohio Hospital Makes the Right Call

An Ohio-based hospital had mystery shoppers call the main phone line. They discovered that operators were transferring several callers to the Ask-a-Nurse line for many questions that didn't apply. Once the problem was uncovered by mystery shoppers, the hospital was able to come up with guidelines and resources for the operators so that they could answer callers' questions and transfer them to the right locations.

A Dallas Facility Improves Scripts & Terminology

A Dallas hospital learned from mystery shopper reports that patients' levels of psychological comfort were low. So, the hospital developed new scripts for speaking with customers. Now, rather than just asking "Can I get anything for you?" staffers are told to add, "I have the time." This small adjustment has done wonders to help patients feel more important and valued. The facility also simplified terminology and enlarged the font on its signs in response to mystery shopper complaints that signs were difficult to read.

A Retirement Community Re-Focuses Its Sales Efforts

A new upscale retirement community was failing to meet its occupancy objectives while several of its competitors were filled to capacity and enjoying waiting lists. The owners had assumed that local residents were simply unaware that the retirement community existed-something that the facility thought would solve itself over time with good public relations. However, mystery shopping reports identified the sales force as the more significant problem. If the mystery shopping audit had not been done, the owners might have focused their energies in the wrong place. They found out that awareness and PR was not the sole problem, and so, they focused their energies in the sales area. They made changes in staff and hired more experienced people with the right skills and personalities to relate to the residents and reflect corporate expectations.

A Midwest Facility Rewards Positive Feedback

In addition to identifying problematic issues, mystery shopping often uncovers examples of outstanding service and performance. A Midwestern nonprofit healthcare organization began rewarding employees who got praise from mystery shoppers with small cash prizes, gift cards, better parking spaces, and public recognition, such as engraving their names on a wall plaque. Since implementing its mystery shopping program, the facility's employee turnover rate dropped to 11.5 percent from nearly 18 percent.

There's No Mystery in the Results

Overall, healthcare facilities that use mystery shoppers say that the reports have led to a number of changes in the patient experience, including improved estimates of wait times, better explanations of medical procedures, escorts for patients who have gotten lost, and even less-stressful programming on the television in the waiting room. Mystery shopping ultimately takes a snapshot of what visitors who come to your facility encounter. This snapshot may or may not be an accurate reflection of how your facility operates on a daily basis. After all, people have bad days, things go wrong, equipment breaks, etc. That's why you should never approach your first mystery shopping experience with the thought that it will be your last. Mystery shopping is most effective if it is ongoing, or conducted on a periodic basis, so you can see real patterns of progress. If you only intend to conduct a mystery shopping project once, remember that there are limitations to the comparative or trend information you collect.

Mystery shopping can ultimately help hospitals, clinics, assisted living facilities and nursing homes identify unsatisfactory processes and employee behavior and performance. By identifying these problems, taking action to resolve them, and then going through the evaluation process once again, healthcare organizations can increase business and customer satisfaction exponentially.

[We] first heard Clint speak at a VHCA seminar 1 year ago - took a suggestion and put it into practice - let staff hire staff - started this immediately after the session - so we finished the year lowering our turnover from 47.4% building wide to 29.7% - and reduced LNA turnover by 13% alone!! Staff very much are vested in new employees and their success is the veteran staff's goal now - much happier workplace as well - not constantly retraining.